The AAFP has asked the House and Senate appropriations subcommittees to increase funding for key primary care-related programs in fiscal year 2011, or FY11, as the federal government prepares to implement provisions of the newly enacted health care reform law, known as the Patient Protection and Affordable Care Act.

In written testimony submitted to House and Senate appropriations subcommittee members, AAFP President Lori Heim, M.D., of Vass, N.C., pointed out that the recently enacted health care reform legislation contains a number of provisions to increase the primary care workforce. For example, it amends and expands many of the existing health workforce programs authorized under Title VII of the Public Health Service Act, and it allows medical education program payments to go to teaching health centers in an attempt to encourage the training of more primary care physicians.

"The Patient Protection and Affordable Care Act holds the promise of health security for Americans and moves us toward genuine health system reform," said Heim. She added, however, "successful implementation of health care reform requires an investment to strengthen our nation's primary care workforce."

The AAFP has long championed Section 747 of Title VII, which provides the only federal grants for training family physicians. In her testimony, Heim urged the committees to provide $170 million for Title VII, Section 747, in FY11, an increase of $116 million from FY10. Heim also asked the committees to provide an appropriation of at least $600 million for all of the health professions training programs authorized under Title VII in FY11, an increase of $346 million from the current fiscal year level.

Heim praised other programs that have led to an increase in the primary care workforce. For example, the National Health Service Corps, or NHSC, has "long served to provide access to health care to underserved Americans" while offering incentives for primary care physicians to enter primary care, she said. The NHSC also provides important student debt relief for new physicians.

"The AAFP recommends that the National Health Service Corps receive $414.1 million in FY11, as authorized in the Patient Protection and Affordable Care Act," Heim said.

The NHSC is funded at $142 million for FY10, but it received $300 million in American Recovery and Reinvestment Act funds in 2009 and 2010.

Heim also lauded the mission of the Agency for Healthcare Research and Quality, or AHRQ, in improving the quality, safety, efficiency and effectiveness of health care, saying that AHRQ's mission closely mirrors that of the AAFP.

"Family physicians recognize that AHRQ has a critical role to play in patient-centered comparative effectiveness research," said Heim. In her testimony, she requested $611 million for AHRQ in FY11, an increase of $213 million from the current fiscal year.

The Patient Protection and Affordable Care Act also created a primary care extension program under AHRQ to provide support and assistance to primary care providers regarding evidence-based therapies and techniques. The AAFP has asked for $120 million for the extension centers in FY11, the same amount authorized by the act.

Heim also praised the creation of rural physician training grants under Section 749B of Title VII in the new health care reform law. These grants will help medical schools recruit students likely to practice medicine in underserved rural communities while increasing the number of recent medical school graduates, she said.

"The AAFP requests that the committee provide $4 million in FY11 for Title VII, Section 749B rural physician training grants," Heim said.

At the same time, the AAFP encouraged the committees to provide $176 million for programs administered by the Health Resources and Services Administration's Office of Rural Health to address the "many unique service needs of rural communities," according to Heim.

"Family physicians provide the majority of care for America's underserved and rural populations," said Heim. "Despite efforts to meet scarcities in rural areas, the shortage of primary care physicians continues."